Nursing Elites

1. What is the priority dietary modification for a patient with pre-dialysis end-stage kidney disease?

• A. Limit phosphorus intake to 700 mg/day
• B. Increase potassium intake to 3 g/day
• C. Eat three large meals per day
• D. Restrict protein intake to 1 g/kg/day

Correct answer: A

Rationale: The correct answer is A: Limit phosphorus intake to 700 mg/day. In patients with pre-dialysis end-stage kidney disease, restricting phosphorus intake is crucial to manage their condition. Excessive phosphorus can lead to mineral and bone disorders, which are common in kidney disease. Choice B, increasing potassium intake, is not the priority and can be harmful as kidney disease often leads to hyperkalemia. Choice C, eating three large meals per day, is not recommended as smaller, frequent meals are usually better tolerated. Choice D, restricting protein intake to 1 g/kg/day, is important in later stages of kidney disease but is not the priority at the pre-dialysis stage.

2. What is the priority action if a patient experiences hypoglycemia after an insulin dose?

• A. Check the patient's blood glucose level
• B. Administer IV dextrose
• C. Document the incident
• D. Continue monitoring the patient

Correct answer: A

Rationale: The priority action when a patient experiences hypoglycemia after an insulin dose is to check the patient's blood glucose level. This is crucial to confirm hypoglycemia before initiating any treatment. While administering IV dextrose may be necessary if the patient's blood glucose level is critically low, confirming hypoglycemia is essential to guide appropriate interventions. Documenting the incident is important for documentation purposes but is not the immediate priority when the patient's safety is at risk. Continuing to monitor the patient is essential, but it should follow the confirmation and initial management of hypoglycemia.

3. A nurse is caring for a client who has a new diagnosis of tuberculosis. Which of the following precautions should the nurse initiate to prevent transmission of the disease?

• A. Contact precautions
• B. Airborne precautions
• C. Droplet precautions
• D. Protective environment

Correct answer: B

Rationale: Tuberculosis is spread through small droplets measuring less than 5 microns, which can remain airborne for extended periods. The nurse should place a client who has TB under airborne precautions to prevent the spread of microbes. Choice A, contact precautions, are used for diseases spread by direct or indirect contact. Choice C, droplet precautions, are for diseases spread by larger droplets. Choice D, protective environment, is used for immunocompromised clients to protect them from environmental pathogens.

4. A client scheduled for electromyography (EMG) will have small needle electrodes inserted into the muscles. What should the nurse include in the teaching?

• A. You will receive a fixed dose of radioisotope 2 hours before the procedure.
• B. Momentary flushing will occur at the beginning of the procedure.
• C. You should inform your provider if you are claustrophobic.
• D. You should expect insertion of small needle electrodes into the muscles.

Correct answer: D

Rationale: The correct answer is D. During an electromyography (EMG) procedure, small needle electrodes are inserted into the muscles to assess muscle weakness and nerve responses. Choices A, B, and C are incorrect because radioisotope is not used in EMG, flushing is not a typical occurrence, and claustrophobia is more relevant for imaging procedures like MRI or CT scans, not EMG.

5. What teaching should be provided to a patient after cataract surgery?

• A. Avoid NSAIDs
• B. Avoid bright lights
• C. Wear dark glasses while outdoors
• D. Use warm compresses

Correct answer: A

Rationale: The correct teaching to provide to a patient after cataract surgery is to avoid NSAIDs. NSAIDs should be avoided to reduce the risk of bleeding post-surgery. Choices B, C, and D are not directly related to post-cataract surgery care. Avoiding bright lights and wearing dark glasses while outdoors may be beneficial for eye comfort but are not specific postoperative instructions. Using warm compresses is also not a standard teaching after cataract surgery.

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